Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MA › QUINCY › SOUTH STREET DENTAL LLC

SOUTH STREET DENTAL LLC

NPI: 1821479445 · QUINCY, MA 02169 · 122300000X

$18K
Total Medicaid Paid
571
Total Claims
563
Beneficiaries
9
Codes Billed
2018-02
First Month
2022-08
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 383 $12K
2019 100 $3K
2020 39 $1K
2022 49 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 181 180 $5K
D1208 113 111 $3K
D4910 40 40 $3K
D1206 67 67 $3K
D1330 97 97 $1K
D4381 16 12 $1K
D1120 26 25 $1K
D1110 15 15 $770.00
D0220 16 16 $254.00